Background: Non-alcoholic fatty liver disease (NAFLD) is considered one of the most common causes of chronic liver disease globally. NAFLD prevalence is increasing in parallel with other manifestations of metabolic syndrome. Diagnosis of liver fibrosis depends on imaging and biopsy. Adiponectin and insulin growth factor 1 (IGF-1) are metabolic markers associated with liver dysfunction. Aim of the study: Was to determine the possibility of using adiponectin and IGF-I in the diagnosis of early-stage nonalcoholic steatohepatitis (NASH) and the validity of the results in older age groups.  Methodology: Comparative cross-sectional study included 60 hepatic patients: 30cases with NASH compared to 30cases with simple steatosis. Both IGF-1 and serum adiponectin were assessed in serum via Enzyme-linked Immunosorbent assay (ELISA). Levels of both analytes were correlated with clinical condition, abdominal ultrasonography (US), immunological and virological data. Results: Adiponectin and IGF-1 levels were significantly lower in the NASH group; compared to the simple steatosis group (p < 0.01). Also, the significant negative correlation between both of them and liver enzymes (p <0.01) reveals that liver and parenchymal dysfunction is linked with lower serum level of IGF-I and adiponectin. Older patient's subgroup analysis showed similar results. Conclusion: Insulin growth factor 1 and Serum adiponectin are less in patients with NASH compared to those with simple steatosis so they can possibly be used in early laboratory diagnosis of NASH. These results are also valid in older age patients.